Online PrEP – the real deal?

How do we know that the PrEP we’re buying online is the real thing?Find out what PrEPster did across the summer of 2018 to test PrEP from six major online sellers.

What’s this new research?

Across the summer of 2018, PrEPster organized trial purchases of online generic PrEP from six of the major online suppliers. We asked volunteers to buy bottles of PrEP from those suppliers and then had the PrEP tested at a laboratory.

Why did you do this research?

Thousands of people are buying their PrEP online especially in countries where PrEP isn’t yet available through health systems. One of the most common questions we get asked is: how do we know that online PrEP is safe? How do we know that the drugs aren’t fake?

But weren’t the drugs already tested?

In 2016 we worked with clinics including Dean Street to undertake hundreds of therapeutic drug monitoring tests – or TDMs. TDMs involve someone taking a drug and then having their blood tested for the drug in their blood. Those TDMs showed that there was no fake PrEP in any of the people tested.

Why are you doing this research now?

In recent years new suppliers have started to sell PrEP – and a couple of new brands of PrEP have come on to the market. So, we thought it was time to reassure all those people who ask us about the drugs they are buying online by doing new pill testing. This new research adds to the TDMs done in 2016.

Were sellers aware of this research?

We put safeguards in place to make sure that this testing process was done to top quality standards. Sellers were not made aware that test purchases were being undertaken. Only a small handful of people knew about this research.

Did you test the real products?

All of the drugs we tested went to the laboratory in their original packaging and all of the pills that were tested arrived in sealed bottles. The laboratory scientist didn’t know which company each of the samples came from. That is: the samples were ‘blinded’.

Is this quality research?

An independent laboratory was used that meets international standards. The results were peer reviewed before they were published at an international HIV conference. The results are available and the methods are open to scrutiny.

What did the research find?

Fourteen different bottles of PrEP from online suppliers were tested. In addition, Truvada and PrEP from the England IMPACT Trial was also tested. The results showed that there’s no evidence of fake PrEP in any of the samples we obtained across the summer of 2018 from any of the six suppliers.

What tests were used?

The laboratory used a fully validated ultra-performance liquid chromatography essay. The test looks for the active ingredients of PrEP (TDF and FTC).

Which companies did you test?

Samples were tested on PrEP from All Day Chemist; Dynamix; Green Cross Pharmacy; In House Pharmacy; Silom Pulse; and United Pharmacy.

So, is online PrEP safe?

These tests add to the evidence from the TDMs undertaken in 2016. That is: we can be very confident that the PrEP we’re buying online is safe and genuine, from the sources that were tested. We continue to strongly urge caution in obtaining PrEP from sources that cannot be traced or verified.

How was this project funded?

The drug purchasing was organized by and paid for by PrEPster. All volunteers received full reimbursement of drug costs (including postage and customs duty as appropriate) and received no other payment. The laboratory costs were paid for by Terrence Higgins Trust and the laboratory testing was undertaken by Imperial College, London.

Isn’t this a way for PrEPster to boost sales of particular companies?

PrEPster does not have a preferred or recommended seller of PrEP. We understand that individuals will make decisions on which seller to use based on factors including price, payment method and speed of delivery.